title: Predictive value of maximum standardized uptake value (SUVmax) on 18F-FDG PET/CT in patients with locally advanced or metastatic pancreatic cancer.
abstract: OBJECTIVE
  We investigated the prognostic role of 18F-FDG PET/CT in the prediction of progression-free survival (PFS) and chemotherapeutic response in patients with locally advanced or metastatic pancreatic cancer.
  
  
  METHODS
  We enrolled 21 newly diagnosed patients with locally advanced or metastatic pancreatic cancer who underwent 18F-FDG PET/CT scanning before palliative gemcitabine-based chemotherapy between 2006 and 2012. Maximum standardized uptake value (SUVmax) of the primary tumor was measured by 18F-FDG PET/CT. Chemotherapeutic response was evaluated according to the Response Evaluation Criteria in Solid Tumors. Survival analysis was performed for time to progression using the Kaplan-Meier method. Cox proportional hazard models were used to determine independent prognostic factors.
  
  
  RESULTS
  All pancreatic tumors showed detectable FDG uptake (mean SUVmax = 6.8 ± 3.0, range 2-12) The mean SUVmax values among response groups showed no significant difference (P = 0.853) and chemotherapeutic response was not different according to SUVmax level (P = 0.807). PFS was significantly shorter in the high SUVmax (≥6.8) group than in the low SUVmax (<6.8) group (2.9 vs. 6 months, P = 0.012). Multivariate analysis revealed that SUVmax was an independent prognostic factor for predicting PFS (P = 0.046).
  
  
  CONCLUSIONS
  Higher SUVmax of primary pancreatic tumor is associated with poor PFS and pretreatment SUVmax is an independent prognostic factor for predicting PFS in patients with locally advanced or metastatic pancreatic cancer who received gemcitabine-based palliative chemotherapy. However, pretreatment SUVmax is not associated with chemotherapeutic response.
authors.affiliation: From the *Departments of Gastroenterology and †Nuclear Medicine, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.
authors.forename: Soo Young
authors.initials: SY
authors.lastname: Moon
authors.forename: Kwang Ro
authors.initials: KR
authors.lastname: Joo
authors.forename: Ye Ri
authors.initials: YR
authors.lastname: So
authors.forename: Jun Uk
authors.initials: JU
authors.lastname: Lim
authors.forename: Jae Myung
authors.initials: JM
authors.lastname: Cha
authors.forename: Hyun Phil
authors.initials: HP
authors.lastname: Shin
authors.forename: You-Jung
authors.initials: YJ
authors.lastname: Yang
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary*; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden
chemical_list: D001786:Blood Glucose; D019788:Fluorodeoxyglucose F18